Gregory James R, Lehman Thomas P, White Jeremy R, Fung Kar-Ming
Orthopedics. 2014 May;37(5):e504-7. doi: 10.3928/01477447-20140430-64.
Chondroblastoma is a rare, benign primary bone tumor that usually occurs at the epiphysis of long bones. The authors present an example of the diagnosis and successful treatment of this neoplasm in an exceedingly rare location in the distal phalanx. Clinical and radiographic outcomes after 68 months of follow-up are presented. A 15-year-old, right hand-dominant, boy developed painful swelling of the right ring finger. Radiographs revealed a radiolucent lesion of the distal phalanx with expansile remodeling of the bone. An excisional biopsy was performed with curettage and bone grafting of the lesion. The diagnosis of chondroblastoma was made based on pathologic evaluation of the biopsy specimen. Sixty-six months after surgical treatment, the patient was free of recurrence and metastatic disease with excellent clinical and functional outcomes. To the authors' knowledge, this represents only the second reported case of chondroblastoma of the distal phalanx. The diagnosis of chondroblastoma in this rare location was made by pathologic review of the resection specimen. It is imperative to confirm the diagnosis of any resected bone specimen even when the concern for an aggressive or malignant lesion is low. A tumor presenting in an unusual location may require a change in treatment or surveillance.
软骨母细胞瘤是一种罕见的原发性良性骨肿瘤,通常发生在长骨的骨骺部位。本文作者展示了一个发生在远节指骨这一极其罕见部位的该肿瘤的诊断及成功治疗的病例,并呈现了68个月随访后的临床及影像学结果。一名15岁、惯用右手的男孩出现右手环指疼痛性肿胀。X线片显示远节指骨有一透亮病变,伴有骨质膨胀性重塑。对病变进行了切除活检,并刮除病变组织后行骨移植。根据活检标本的病理评估确诊为软骨母细胞瘤。手术治疗66个月后,患者无复发及转移疾病,临床及功能结果良好。据作者所知,这是仅有的第二例报道的远节指骨软骨母细胞瘤病例。该罕见部位的软骨母细胞瘤诊断是通过对切除标本的病理检查做出的。即使对侵袭性或恶性病变的担忧较低,对任何切除的骨标本进行诊断确认也是至关重要的。出现在不寻常部位的肿瘤可能需要改变治疗或监测方案。